I mean it’s ultimately what you are going to get out of it, in a 10 min consultation so if you are going to use it for those things… because you have to do it for QOF because you have to do it to augment a referral or get the referral in, if you have to do it for persuasion… you know you will use that in a 10 min consultation but if it doesn’t confer you any benefit to do that… with time constraints you are going to go to your, if you like less measured, softer clinical skills in how you find the patient. FG2R6 (family physician, medically qualified 10 years)